Growth, development and neonatal care

40 Staff nurse recruitment practice questions on Growth, development and neonatal care, part of Child Health Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Easy
A child is usually first able to copy a square drawn on paper at the age of:
1. A2 years
2. B6 years
3. C4 years
4. D3 years
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Answer: C · 4 years
Copying shapes is a fine motor and visual-perceptual milestone used in developmental screening. A child copies a circle at about 3 years, a cross and a square at about 4 years and a triangle at about 5 years. Each shape needs more control of direction and corners than the one before. A school-entry child who cannot copy a square deserves assessment.
- A: At 2 years a child scribbles and imitates a stroke but cannot copy shapes.
- B: By 6 years the child copies a diamond and writes letters; the square came earlier.
- D: A circle, not a square, is the shape copied at 3 years.
Question 2 · Hard
A healthy 10-year-old boy's expected weight by the formula weight (kg) = (age in years x 7 - 5) / 2 is:
1. A65.0 kg
2. B35.0 kg
3. C32.5 kg
4. D28.0 kg
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Answer: C · 32.5 kg
Multiply the age by 7: 10 x 7 = 70. Subtract 5: 70 - 5 = 65. Divide by 2: 65 / 2 = 32.5 kg. This formula is used for children aged 7-12 years, while (age x 2) + 8 is used from 1 to 6 years.
- A: 65.0 kg comes from forgetting to divide by 2.
- B: 35.0 kg comes from forgetting to subtract 5 before dividing.
- D: 28.0 kg comes from using the 1-6 year formula, (age x 2) + 8.
Question 3 · Medium
The usual daily dose of oral vitamin D supplement for a breastfed preterm baby is:
1. A4000 IU
2. B400 IU
3. C40 IU
4. D60,000 IU
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Answer: B · 400 IU
Breast milk is low in vitamin D, and preterm babies have small stores because most transfer happens late in pregnancy. A daily supplement of 400 IU is routinely given to preterm and low birth weight babies to prevent rickets and metabolic bone disease. It is continued through infancy. Large single doses are reserved for treating rickets, not prevention.
- A: Four thousand IU daily is a treatment-level dose that risks toxicity in a small baby.
- C: Forty IU is far too little to prevent deficiency.
- D: Sixty thousand IU is a single therapeutic (stoss) dose for rickets, not a daily dose.
Question 4 · Medium
A 4-year-old tells the nurse that the moon follows him when he walks and that his teddy feels sad when left alone. In Piaget's theory, this thinking belongs to the:
1. AConcrete operational stage
2. BSensorimotor stage
3. CFormal operational stage
4. DPreoperational stage
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Answer: D · Preoperational stage
Piaget's preoperational stage lasts from about 2 to 7 years. Thinking is egocentric and magical, and children show animism, giving life and feelings to objects such as a moon or a toy. Nurses use play, dolls and simple concrete explanations to prepare children of this age for procedures. Logical reasoning about real objects comes in the concrete operational stage.
- A: Concrete operational children (7-11 years) reason logically and no longer believe objects have feelings.
- B: The sensorimotor stage (0-2 years) is learning through senses and movement, before symbolic thought.
- C: Formal operational thinking (from about 11 years) is abstract and hypothetical.
Question 5 · Medium
In a healthy 9-month-old, stroking the sole of the foot makes the big toe go up and the other toes fan out. This finding is:
1. AA sign of spinal cord injury
2. BA sign of cerebral palsy
3. CNormal for this age
4. DA sign of meningitis
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Answer: C · Normal for this age
This is the Babinski (plantar extensor) response. It is normal in infants because the corticospinal tracts are not yet fully myelinated, and it usually changes to a flexor response between 1 and 2 years, once walking is established. A persistent extensor response after about 2 years suggests an upper motor neuron lesion. In a healthy 9-month-old no action is needed.
- A: Spinal cord injury is a concern only when the sign appears beyond infancy with other deficits.
- B: Cerebral palsy is not suggested by a finding that is normal at this age.
- D: Meningitis presents with fever, irritability and a bulging fontanelle, not this reflex alone.
Question 6 · Hard
Which baby in the KMC ward meets the usual criteria for discharge home with continued kangaroo mother care?
1. ABreastfeeds well, warm in KMC, but has lost weight over the last 3 days
2. BBreastfeeds well and gaining weight but had an apnoea episode yesterday
3. CBreastfeeds well, warm in KMC, gaining 15 g/kg/day for 3 days, mother confident
4. DGaining 20 g/kg/day for 3 days but still fed only by orogastric tube
Answer and explanation in LearnFree account
Question 7 · Easy
The first milk tooth to erupt in most infants is the:
1. ALower first molar
2. BUpper canine
3. CLower central incisor
4. DUpper lateral incisor
Answer and explanation in LearnFree account
Question 8 · Hard
A low birth weight baby in kangaroo mother care weighs 1,500 g on the first day and 1,605 g five days later. What is the average weight gain?
1. AAbout 70 g/kg/day
2. BAbout 14 g/kg/day
3. CAbout 21 g/kg/day
4. DAbout 7 g/kg/day
Answer and explanation in LearnFree account
Question 9 · Easy
Most healthy children start walking alone, without holding on to furniture, at about:
1. A20-24 months
2. B30-36 months
3. C6-8 months
4. D12-15 months
Answer and explanation in LearnFree account
Question 10 · Easy
As the first step of the warm chain, the room where a baby is born should be kept at a temperature of about:
1. A18-20 °C
2. B21-23 °C
3. C32-35 °C
4. D25-28 °C
Answer and explanation in LearnFree account
Question 11 · Hard
A baby is born at 38 weeks' gestation weighing 1,400 g, a weight below the 10th centile for that gestation. How is this baby classified?
1. APreterm, low birth weight, appropriate for gestational age
2. BTerm, low birth weight, appropriate for gestational age
3. CPreterm, extremely low birth weight, small for gestational age
4. DTerm, very low birth weight, small for gestational age
Answer and explanation in LearnFree account
Question 12 · Hard
A term baby under phototherapy has an axillary temperature of 37.9 °C. Her eyes are covered, she breastfeeds well, and the unit is closer than the recommended distance in a warm room. What should the nurse do first?
1. AStop phototherapy completely for the next 24 hours
2. BReset the lamp distance and recheck the temperature
3. CGive oral paracetamol and continue phototherapy
4. DWrap the baby in a warm blanket under the lights
Answer and explanation in LearnFree account
Question 13 · Medium
A stable baby born at 35 weeks weighs 2.2 kg, is alert and roots and sucks well. The best method of feeding is:
1. APaladai feeding of formula
2. BOrogastric tube feeding
3. CDirect breastfeeding
4. DIntravenous fluids only
Answer and explanation in LearnFree account
Question 14 · Medium
To measure the head circumference of an infant, the non-stretchable tape is passed around the head over the:
1. ATips of the ears and the nape of the neck
2. BMastoid processes and the bridge of the nose itself
3. CVertex of the head and the point of the chin
4. DOccipital protuberance and just above the eyebrows
Answer and explanation in LearnFree account
Question 15 · Easy
The first permanent tooth to erupt, at about 6 years of age, is usually the:
1. ACanine
2. BSecond molar
3. CFirst molar
4. DSecond premolar
Answer and explanation in LearnFree account
Question 16 · Medium
In the kangaroo position, the baby's head should be:
1. AAllowed to fall back freely without support
2. BBent forward with the chin on the chest
3. CTurned to one side and slightly extended
4. DTurned face down between the two breasts
Answer and explanation in LearnFree account
Question 17 · Easy
Most children can hop on one foot a few times by the age of:
1. A7 years
2. B4 years
3. C2 years
4. D18 months
Answer and explanation in LearnFree account
Question 18 · Easy
A healthy child's birth length usually doubles by the age of:
1. A2 years
2. B4 years
3. C1 year
4. D8 years
Answer and explanation in LearnFree account
Question 19 · Medium
A 10-month-old always reaches for toys with the left hand and never uses the right. How should the nurse interpret this?
1. APossible right-sided weakness needing review
2. BExpected one-sided play at this age
3. CA sign of advanced fine motor development
4. DNormal early left-handedness in the child
Answer and explanation in LearnFree account
Question 20 · Medium
Physiological jaundice in a newborn is partly due to low activity of which liver enzyme?
1. AAlkaline phosphatase
2. BAlanine aminotransferase
3. CGlucose-6-phosphate dehydrogenase
4. DUridine diphosphate glucuronyl transferase
Answer and explanation in LearnFree account
Question 21 · Easy
For growth monitoring, the length of a child under 2 years of age should be measured with the child:
1. ASitting on a level surface
2. BLying flat on an infantometer
3. CStanding against a wall scale
4. DHeld upright by the mother
Answer and explanation in LearnFree account
Question 22 · Medium
The mother of a jaundiced 3-day-old plans to keep the baby in direct sunlight at home to treat the jaundice. What should the nurse explain?
1. ASunlight helps only once soles turn yellow
2. BSunlight is safe if the baby stays clothed
3. CSunlight works as well as phototherapy
4. DSunlight is unreliable and unsafe as treatment
Answer and explanation in LearnFree account
Question 23 · Hard
After the age of 2 years, expected height in centimetres can be estimated as six times the age in years plus 77. For a healthy 6-year-old girl this gives:
1. A83 cm
2. B107 cm
3. C125 cm
4. D113 cm
Answer and explanation in LearnFree account
Question 24 · Easy
A newborn whose birth weight is below the 10th centile for the gestational age is described as:
1. APreterm
2. BVery low birth weight
3. CPost-term
4. DSmall for gestational age
Answer and explanation in LearnFree account
Question 25 · Medium
Frequent breastfeeding in the first days of life lowers the newborn's bilirubin level mainly by:
1. ASlowing the destruction of fetal red cells
2. BSpeeding meconium passage and cutting gut reabsorption
3. CSupplying the conjugating enzyme in the milk
4. DDirectly breaking down bilirubin in the blood
Answer and explanation in LearnFree account

15 more Growth, development and neonatal care questions

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Growth, development and neonatal care

A child is usually first able to copy a square drawn on paper at the age of:

A healthy 10-year-old boy's expected weight by the formula weight (kg) = (age in years x 7 - 5) / 2 is:

The usual daily dose of oral vitamin D supplement for a breastfed preterm baby is:

A 4-year-old tells the nurse that the moon follows him when he walks and that his teddy feels sad when left alone. In Piaget's theory, this thinking belongs to the:

In a healthy 9-month-old, stroking the sole of the foot makes the big toe go up and the other toes fan out. This finding is:

Which baby in the KMC ward meets the usual criteria for discharge home with continued kangaroo mother care?

The first milk tooth to erupt in most infants is the:

A low birth weight baby in kangaroo mother care weighs 1,500 g on the first day and 1,605 g five days later. What is the average weight gain?

Most healthy children start walking alone, without holding on to furniture, at about:

As the first step of the warm chain, the room where a baby is born should be kept at a temperature of about:

A baby is born at 38 weeks' gestation weighing 1,400 g, a weight below the 10th centile for that gestation. How is this baby classified?

A term baby under phototherapy has an axillary temperature of 37.9 °C. Her eyes are covered, she breastfeeds well, and the unit is closer than the recommended distance in a warm room. What should the nurse do first?

A stable baby born at 35 weeks weighs 2.2 kg, is alert and roots and sucks well. The best method of feeding is:

To measure the head circumference of an infant, the non-stretchable tape is passed around the head over the:

The first permanent tooth to erupt, at about 6 years of age, is usually the:

In the kangaroo position, the baby's head should be:

Most children can hop on one foot a few times by the age of:

A healthy child's birth length usually doubles by the age of:

A 10-month-old always reaches for toys with the left hand and never uses the right. How should the nurse interpret this?

Physiological jaundice in a newborn is partly due to low activity of which liver enzyme?

For growth monitoring, the length of a child under 2 years of age should be measured with the child:

The mother of a jaundiced 3-day-old plans to keep the baby in direct sunlight at home to treat the jaundice. What should the nurse explain?

After the age of 2 years, expected height in centimetres can be estimated as six times the age in years plus 77. For a healthy 6-year-old girl this gives:

A newborn whose birth weight is below the 10th centile for the gestational age is described as:

Frequent breastfeeding in the first days of life lowers the newborn's bilirubin level mainly by: